What is a LEEP procedure?
If precancerous cell changes in your cervical tissue, also known as cervical dysplasia, are found after performing a pap test, colposcopy, or cervical tissue sample, Dr. Aliabadi may choose to remove the abnormal tissue surgically. Removing these abnormal cervical cells can reduce the risk and spread of cancer.
Two common ways to remove precancerous cells are the loop electrosurgical excision procedure (LEEP procedure) or a cold knife cone biopsy. A LEEP procedure can test and treat cervix cells.
How is the LEEP performed?
A LEEP can usually be performed in our gynecologist’s office.
You will lie on the exam table with your feet in stirrups during the procedure. Using a speculum, Dr. Aliabadi will open your vagina to gain access to your cervix, much like during a regular pelvic exam. She will then inject a numbing anesthetic agent into your cervix.
An iodine solution will be added to your cervix to make the abnormal cells visible, and Dr. Aliabadi will then place a special lighted microscope called a colposcope near the opening of your vagina. The colposcope will remain outside of your vagina, providing a magnified view of your cervix.
The LEEP instrument is a tool with a thin wire loop on the end. It is inserted through the speculum until it reaches the cervix.
Once in position, an electric current is passed through the wire, causing it to heat up. The heated wire can then remove a small tissue sample, which can be tested for cancer. Our provider may apply medicated pastes or creams to prevent heavy bleeding. The goal of the procedure is to remove the abnormal cells to decrease the chances of cancer.
What to expect after a LEEP procedure?
The LEEP procedure usually takes less than 20 minutes. It’s an outpatient procedure, so when you feel ready, you can go home. You may experience some unpleasant LEEP procedure side effects after your surgery, including:
- Mild cramping. You can take over-the-counter ibuprofen or use heated pad to manage the pain.
- Vaginal discharge for 1-3 weeks.
- Discharge that is dark or brown.
Avoid putting anything into your vagina for the first 3-4 weeks. Dr. Aliabadi may also recommend avoiding strenuous exercise or heavy lifting during this time. Abstain from sexual intercourse and use pads instead of tampons to absorb blood. Douching is not recommended.
Complications are rare, but you will want to call Dr. Aliabadi if you’re experiencing worsening symptoms or any signs of infections, such as:
- High-grade fever, nausea
- Foul-smelling discharge
- Worsening pain
- Severe bleeding or clotting – going through at least one pad each hour
About 3-4 months after your procedure, schedule a follow-up appointment with Dr. Aliabadi. She may perform another pap smear to monitor the cells of your cervix.
Benefits of the LEEP procedure
LEEP is a safe, effective, and precise surgery that removes only a small amount of healthy tissue and abnormal cells. It is performed in a doctor’s office, making it less costly than a biopsy or laser treatment. LEEP doesn’t require a lengthy recovery or a hospital stay.
What is a cold knife cone biopsy?
Cone knife biopsy is a complicated procedure and is typically performed in the hospital under general anesthesia. It removes a larger, cone-shaped sample of tissue from the cervix.
Instead of an electrically charged wire, a surgical knife or scalpel is usually used for cervical conization. Dr. Aliabadi may cauterize the area to seal blood vessels and prevent heavy bleeding. The removed sample can be evaluated in the lab for signs of cancer.
The goal of the surgery is to remove abnormal tissue before the dysplasia becomes cancerous. Recovery from cold knife cone biopsy is often longer than recovery from the LEEP procedure. You may experience pain and discomfort for a week, as well as heavy discharge or bleeding for two to three weeks.
What do my test results mean?
When a sample of abnormal cervical tissue is removed via LEEP or cold knife cone biopsy, it is sent to the lab for testing. Within a few days, Dr. Aliabadi can tell you the results. While a Pap test or colposcopy can indicate abnormal cells that may be cancerous or precancerous, a LEEP or cold knife cone biopsy can tell whether these cell changes are due to cancer or caused by other abnormalities, like polyps.
Precancerous cervical cells are known as cervical intraepithelial neoplasia (CIN), and there are three grades of severity.
- CIN I – Mild dysplasia
- CIN II – Moderate dysplasia
- CIN III – Severe dysplasia or carcinoma
LEEP is generally very effective at removing abnormal cells. Dr. Aliabadi will discuss your results with you and make recommendations for follow-up appointments. Many women are advised to have a Pap smear within six months to a year to ensure no abnormal cells have returned.
What are the risks of LEEP procedure and cold knife cone biopsy?
As far as surgical procedures go, these techniques are quite safe. There are, however, some risks involved that you should discuss with Dr. Aliabadi, including:
- Cervical stenosis. This is a complication in which the cervix narrows, making it more difficult to become pregnant naturally.
- Preterm birth. Studies have shown that LEEP and cold knife cone biopsy can lead to a syndrome known as an incompetent cervix, which may result in premature labor and delivery during future pregnancies.
- Cervical scarring. Adhesions on the cervix may cause pain during your period, fertility problems, and delivery problems.
- Tissue damage, including damage to the bladder or bowel.
- Blood clots
- Hemorrhaging
- Infection
How can I decrease my risk of cervical cancer?
There are a few steps you can take to reduce your chances of cervical cancer.
- Get vaccinated against HPV. The Gardasil HPV vaccine is recommended for women and men over the age of 9 to protect against the strains of human papillomavirus most likely to cause cervical cancer.
- Practice safe sex. Use condoms and limit your sexual partners.
- Quit smoking. Smoking harms your immune system and has been shown to increase the risk of cervical cancer.
- Attend regular check-ups.
For more information about our advanced outpatient surgical procedures, including the LEEP procedure and cold knife cone biopsy, please visit our Outpatient Hysterectomy Center website.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi isn’t only an expert OB/GYN but is knowledgeable in all aspects of women’s health and well-being. While she can’t treat your heart attack, Dr. Aliabadi and her caring, supportive staff are available to support you through menopause, childbirth, infertility, or even just routine gynecological care.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
LEEP Procedure & Cold Knife Cone Biopsy FAQs
What are the chances of cervical cancer after LEEP?
The chances of developing cervical cancer after a LEEP procedure are generally low, especially if the abnormal cells were entirely removed. Regular follow-up screenings with our gynecologist are essential for monitoring.
What are the long-term side effects of LEEP procedure?
Most women experience no significant long-term issues. However, potential long-term side effects may include changes in menstrual cycles, potential cervical incompetence in future pregnancies, and a slight risk of preterm birth.
What are the differences between cone biopsy vs. LEEP?
A cone biopsy involves removing a cone-shaped piece of cervical tissue for examination and can be done with a scalpel, while LEEP uses a thin wire loop and electric current to remove tissue. LEEP is often less invasive, removes less tissue, and has a shorter recovery time.
How long can you bleed after a LEEP procedure?
Light bleeding or spotting can occur for up to two weeks after a LEEP procedure, but heavier bleeding should be reported to a healthcare provider.
Sources
Loop Electrosurgical Excision Procedure (LEEP). https://www.acog.org/womens-health/faqs/loop-electrosurgical-excision-procedure
HO Guidelines for Treatment of Cervical Intraepithelial Neoplasia 2–3 and Adenocarcinoma in situ: Cryotherapy, Large Loop Excision of the Transformation Zone, and Cold Knife Conization. https://www.ncbi.nlm.nih.gov/books/NBK206769/
Cold Knife Conization. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cold-knife-conization
Cervical Cancer Screening. https://progressreport.cancer.gov/detection/cervical_cancer
Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.